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i-human Kecia Young Medical Case / Quality Documents,Well GRADED A+. Genes related to Celiac disease Ms Schilling case - CORRECT ANSWERS -HLA-DQ2 HLA-DQ8 on chromosome 6 but other factors important because 40% of population has these variants, not a great screening test. 64 other associated gen...

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  • September 30, 2024
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  • 2024/2025
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i-human Kecia Young Medical Case / Quality
Documents,Well GRADED A+.
Genes related to Celiac disease Ms Schilling case - CORRECT ANSWERS -HLA-DQ2
HLA-DQ8 on chromosome 6 but other factors important because 40% of population has
these variants, not a great screening test. 64 other associated genes in Celiac. 40 of
these genes interact with each other and influence TNF and IL-15

Histology and Celiac disease Ms. Schilling case - CORRECT ANSWERS -3 coverings
of the GI tract: plicae circulares, villi, microvilli. Blunting and truncation of villi, increase
in interepithelial lymphocytes, crypt hyperplasia, lymphocyte infiltration into crypts (they
should be in lamina propira)

Absorption and digestion factors in Celiac disease Ms. Schilling - CORRECT
ANSWERS -Specific enzymes and transport proteins on the cell surface of mucosal
cells to finish digestion. Less energy coming in and being utilized than usual. Lipid
absorption will also be affected due to less cells and villi on the surface. Losing surface
area, enzymes, and transport proteins.

Micronutrients in Celiac for Ms. Schilling - CORRECT ANSWERS -Generalized problem
with clotting, slightly low hemoglobin, protein digestion/absorption affected (low albumin
which is 60% of protein in circulation), liver function looking ok, pancreatic enzymes are
low but in normal level so not playing role in disease of the patient.

Clues about the patient's stool for Ms. Schilling - CORRECT ANSWERS -If floating high
fat content, if watery the colon is not able to absorb water, urgency also indicates more
water in stool

Role of the gallbladder for Ms. Schilling - CORRECT ANSWERS -Patient had
gallstones, gallbladder is responsible for making bile so could be recurrence of
gallstones. Gallstones can be stuck in gallbladder and often in the sphincter of Oddi
area. This could be the reason for her pain.

Differential diagnoses for Ms. Schilling - CORRECT ANSWERS -Gluten sensitivity,
gallstones, irritable bowel syndrome, pancreatitis maybe (but usually related to alcohol
use), substance abuse--possibly laxative abuse in this case, ulcerative colitis,
anxiety/stress, cancer, giardiasis (from contaminated water)

Significant findings for Ms. Schilling - CORRECT ANSWERS -Low albumin (protein)
levels (malabsorption), gall stones were present but no signs of inflammation,
macrocytic anemia due to low vitamin B12 (malabsorption), positive for glandin IgA and
glandin IgG antibodies (Celiac), positive endomysial Ab screen (Celiac)

Findings which support Ms. Schilling's diagnosis - CORRECT ANSWERS -Diarrhea
(with fecal fat) associated with abdominal pain worsened with wheat products, weight

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